A Case of Right Sleeve Pneumonectomy and Carinal Reconstruction using Femoro - femoral Cardiopulmanary Bypass / 대한마취과학회지

ABSTRACT

A 26 year-old woman was scheduled for right sleeve pneumonectomy and carinal reconstruction using Femoro-femoral extracorporeal circulation to correct tracheal stenosis due to endotracheal tuberculosis. Only 0.2 mg glycopyrrolate was given intramuscularly for premedication. A radial artery cannulation was inserted for blood has sampling and direct arterial pressure monitoring. Under the monitoring for SaO2, ECG and direct radial artery pressure, we conducted continuous epidural anesthesia for the cannulation of extracorporeal circulation. Immediately after establishment of lines for extracorporeal circulation, we injected 15 mg midazolam, 200 ug fentanyl and 50 mg succinylcholine, and then did orotracheal intubation. Under extracorporeal circulation, right sleeve pneumonectomy was performed, and left bronchial intubation was done using another sterile armored tube number 7.0 by surgeon. From skin incision to left bronchial intubation, maintenance of anesthesia was conducted by intermittent injection of fentanyl-midazolam, and after left bronchial intubation, it was done by using conventional inhalation anesthetics, halothane-98% O2. The prime importance in anesthetic management of these patient should be focused on the maintenance of adequate oxygenation and ventilation, and we think it is a kind of safe method to use extracorporeal circulation during carinal reconstruction.